Find out which disability program you qualify for and how to apply
If you suffer a debilitating injury in Tennessee, there are 2 programs administered by the United States Social Security Administration (SSA) that may provide you with benefits: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
In this article, we’ll take a close look at both programs, and explain how they differ from and interact with workers’ compensation insurance.
What is Social Security Disability Insurance (SSDI)?
SSDI is a program that pays disability benefits to people who can’t work because they have a medical condition (mental or physical). The program is funded through payroll taxes.
To qualify for SSDI, you must meet the following conditions:
- Have a medical condition that renders you disabled, and
- Have accumulated enough work credits (the number of work credits you must have accumulated depends on your age).
How does the SSA define “disabled”?
To qualify for SSDI, it’s not enough to be considered “disabled” under your definition or even your doctor’s definition. To qualify for SSDI, you must meet the SSA’s definition of disabled.
The SSA considers you disabled if:
- You can’t perform the work you performed prior to your medical condition,
- You’re unable to engage in substantial gainful activity (unable to earn more than $1,260 per month in any job) because of your medical condition, and
- Your disability has lasted or is expected to last for at least 1 year or result in death.
There are certain medical conditions recognized by the SSA that are considered automatically disabling.
What is Social Security Income (SSI)?
SSI and SSDI are both managed through the SSA. What’s more, they are both designed to provide benefits to people who have disabilities that prevent them from working.
The main difference between SSI and SSDI is that SSI has an additional need-based requirement. In order to receive SSI, your “countable resources” must not be worth more than $2,000 for an individual or $3,000 for a couple.
What is considered a countable resource?
Resources are simply things you own. The SSA considers most resources countable, including:
- Life insurance
- Most personal property
Some resources are not considered countable, such as:
- The home you live in
- Personal effects (your wedding ring, etc.)
- Small insurance policies with a face value of $1,5000 or less
- Burial spaces for your immediate family
Learn more about countable resources.
Can I receive Social Security disability benefits and workers’ compensation?
Workers’ compensation is a form of insurance that pays medical expenses and lost wages to employees who are injured while doing their job.
It’s important to understand that workers’ compensation is very different from SSDI and SSI.
First of all, it’s your employer’s responsibility to carry workers’ compensation insurance (and not all employers are required to carry workers’ compensation insurance).
Second, the eligibility requirements for workers’ compensation are completely different from the eligibility requirements for SSDI and SSI.
Third, the formula for determining the amount of workers’ compensation benefits you’ll receive is different from the formula that determines how much SSDI or SSI benefits you’ll receive.
Importantly, receiving workers’ compensation does NOT disqualify you from receiving SSDI or SSI. However, if the combined amount of your workers’ compensation insurance and SSDI or SSI benefits exceed 80% of your average earnings before you became disabled, your benefits will be reduced until they total 80%.
Let’s look at an example:
Jared applies for SSDI and receives $1,000 in benefits per month. He also applies for workers’ compensation and receives $1,000 per month. Because Jared’s total benefits ($2,000) exceed 80% of his pre-injury salary, his benefits will be reduced to 80% ($1,600).
How do I file for Social Security disability benefits?
There are 3 ways to apply for Social Security disability benefits in Tennessee:
- You can apply online
- You can apply over the telephone by calling 1-800-772-1213 (1-800-325-0778 if you are deaf or hard of hearing)
- You can visit your local Social Security office and apply in person
Regardless of which option you choose, you’ll need to have the following information handy:
- All medical records in your possession
- Workers’ compensation information (settlement agreement, date of injury, claim number)
- Names and dates of your minor children and your spouse
- Checking or saving account numbers
Can I appeal if my application has been denied?
Once you receive your decision, you have 60 days to appeal.
Here’s what an appeal looks like:
- Reconsideration. Someone who didn’t take part in reviewing your initial application will reconsider your application.
- Hearing with an administrative law judge. If your reconsideration is denied, you can request an in-person hearing with the Office of Adjudication and Review (ODAR).
- Review by Appeals Council. The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct.
- Federal court review. Your last chance at receiving benefits is appealing to the federal district court.
If you believe you’re entitled to workers’ compensation benefits or Social Security benefits, schedule a free consultation with a Tennessee attorney near you.